The effects of application of 0.5% levobupivacaine together with 5 mg dexamethasone for infra-clavicular block in surgical treatment of forearm fractures
Abstract
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Objective: We aimed to investigate the effects of adding 5mg dexamethasone to 0.5% levobupivacaine on postoperative analgesia after US-guided infra-clavicular block. Methods: This prospective study was performed at Sehitkamil Goverment Hospital, Gaziantep, Turkey, between september 2012 and february 2013. Ninty patients presented with fracture of forearm bones. Patients were randomly allocated to receive ultrasound guided infraclavicular brachial plexus blockade using levobupivacaine 0.5% in conjunction with or without dexamethasone 5 mg. In Group I (n=45), 0.9% NaCl was added as adjuvant. In Group II (n=45), 5 mg dexamethasone was added to 0.5% levobupivacaine and surgical anesthesia was provided. Postoperative pain control was provided by using morphine with intravenous patient controlled analgesia (IVPCA). one mg bolus dose was administered, continued with limit of 5 mg/hour and 10 min of locking time. Verbal ranting scala (VRS), patient satisfaction score (PSS) and total morphine consumption were controlled for postoperative 48 hours. Results: Sensory block onset time was significatly longer in group I. Sensory block time was longer in group II. PSS was higher in group II, total morphine consumption was found more in group I, VRS was significantly higher in group I. Conclusion: Application of 0.5% levobupivacaine together with 5 mg dexamethasone for infra-clavicular block in surgical treatment of forearm fractures reduces sensory block initiation time, prolongs duration of Sensorial Block and reduces analgesic consumption. |
Keywords
Kaynakça
- 1. Chin KJ, Singh M, Velayutham V et. al. Infraclavicular brachial plexus block for regional anaesthesia of the lower arm. Anesth Analg 2010; 111: 1072.
- 2. De Tran OH, Clemente A, Doan J et. al. Brachial plexus blocks: a review of approaches and techniques. Can J Anaesth 2007; 54: 662-74.
- 3. Klaastad Ø, Smith HJ, Smedby O et. al. A novel infraclavicular brachial plexus block: the lateral and sagittal technique, developed by magnetic resonance imaging studies. Anesth Analg 2004; 98(1): 252-6.
- 4. Halasznski TM. Ultrasound brachial plexus anesthesia for upper extremity surgery: Essentials of our current understanding, 2011. Curr Opin Anaesthesiol 2011; 24: 581-91.
- 5. Gürkan Y, Acar S, Solak M et. al. Comparison of nerve stimulation vs. ultrasound-guided lateral sagittal infraclavicular block. Acta Anaesthesiol Scand 2008; 52(6): 851-5.
- 6. Liu S, Carpenter RL, Chiu AA et. al. Epinephrine prolongs duration of subcutaneous infiltration of local anesthesia in a dose-related manner. Correlation with magnitude of vasoconstriction. Reg Anesth 1995; 20: 378–384.
- 7. McCartney CJL, Duggan E, Apatu E. Should we add clonidine to local anesthetic for peripheral nerve blockade? A qualitative systematic review of the literature. Reg Anesth Pain Med 2007; 32: 330–338
- 8. Förster JG, Rosenberg PH. Clinically useful adjuvants in regional anaesthesia. Curr Opin Anaesthesiol 2003; 16: 477–486.
Ayrıntılar
Birincil Dil
İngilizce
Konular
Sağlık Kurumları Yönetimi
Bölüm
Araştırma Makalesi
Yazarlar
Ertugrul Kilic
Dept of Anesthesiology and Reanimation, Şehitkamil State Hospital, Gaziantep
Türkiye
Burcin Karsli
Bu kişi benim
Dept of Orthopedics, Şehitkamil State Hospital, Gaziantep
Türkiye
Mustafa Evrenos
Dept of Plastic Surgery, Şehitkamil State Hospital, Gaziantep
Türkiye
Murat Erkek
Bu kişi benim
Dept of Orthopedics, Şehitkamil State Hospital, Gaziantep
Türkiye
Ayse Mizrak
Bu kişi benim
Dept of Anesthesiology and Reanimation, Gaziantep University Medical School, Gaziantep
Türkiye
Yayımlanma Tarihi
30 Kasım 2017
Gönderilme Tarihi
29 Ekim 2017
Kabul Tarihi
9 Kasım 2017
Yayımlandığı Sayı
Yıl 1970 Cilt: 4 Sayı: 11